MAINTENANCE – More than a quarter of psoriasis cases start during adolescence. Improving the quality of life of young patients requires better information for relatives.
Psoriasis is a common inflammatory disease that remains, however, poorly understood by the general public. It can be triggered at any age, including adolescence, a particularly delicate period, during which the relationship with the body and with regard to the other evolves. On the occasion of the Paris Dermatological Days, Why actor asked Pr Hervé Bachelez, dermatologist at CHU Saint-Louis Lariboisière (Paris). For this specialist, the important thing is to properly inform the young patient and his entourage about the nature of this disease, in order to avoid discomfort in adolescents, and reactions of rejection.
Is adolescence a turning point for the development of psoriasis ?
Hervé Bachelez: The majority of cases start before age 40, and among them, between 25 and 30% of cases develop before age 18, so this is indeed a turning point. It is also a particularly sensitive time, as adolescents are highly prone to depression. [le suicide est la deuxième cause de mortalité chez les adolescents, ndlr], and psoriasis can be difficult to cope with, so you have to be vigilant.
Precisely, for parents who are worried: how to properly supervise a sick teenager?
Herve Bachelez : The important thing is to communicate well with the teenager’s entourage – which is not limited to the family, but also at school for example – and to ensure that everyone has a good perception of the disease: it is not contagious, it is not dirty, etc. These are important messages that will help teens cope better with psoriasis.
Do’can psychological support be useful?
Hervé Bachelez: A psychological approach is relevant (but absolutely not mandatory) if it complements medical treatment. If psoriasis is a disease sensitive to stress, it is above all a disease that arises from the skin! There is a rejection of the disease at the time of adolescence which can result in an irregularity in the taking of the treatment, so this one must be the simplest and the most effective possible.
Are there specific treatments or, on the contrary, not recommended for adolescents?
Hervé Bachelez: Almost all treatments are possible in adolescents. However, you must be careful about the use of certain corticosteroids by local route, because there may be a development of stretch marks in the armpits and thighs. You should therefore not use topical corticosteroids for too long. As soon as psoriasis exceeds 10% of the body’s surface, do not hesitate to switch to classic adult treatments such as phototherapy, or acitretin (sold under the name Soriatane), which are very well tolerated by teenagers.
Will a teenager who develops psoriasis be sick their entire life?
Hervé Bachelez: We cannot know in advance whether the disease will last. But the more diffuse and early onset a psoriasis, the more likely it is to become chronic.
And if one of the children is affected, will his siblings also develop it?
Hervé Bachelez: Regarding heredity, psoriasis is a genetic disease: if one of the parents is affected, children have a 15% risk of developing the disease, compared to 2-3% in general in society. And if a sibling is affected, then there is a risk of around 10 to 12% that the other siblings will in turn develop psoriasis. But we must emphasize one thing: psoriasis is the work of complex genetics and is not automatic.
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